Dermatoscope Performance In Basal Cell Carcinoma And Correlation Research With Histopathological Changes

Objective:To investigate the value of using dermoscopy to diagnose basal cell carcinoma,to search the relationships between dermoscopic of different manifestations of pathological types.Methods:51 patients(male 27 cases,female 24 cases,age from 24-83 years old,the average age is 64±13.56 years)diagnosed as basal cell carcinoma from our hospital clinic patiens were selected.They all visiting our hospital during May 2016-November 2017.Using both dermoscopic and histopathology to diagnose the patients and divide into groups according to endoscopicand pathological features to analyze the correspondence between dermoscopic manifestations and pathological changes.The final results were analyzed by SPSS16.0 software.Chi-square test was used to evaluate the consistency of dermoscopic and pathological types,use α=0.05 as test level,when P<0.05 it is statistically significant.To compare the imparity in 4 dermoscopic types’ pathological changes,using Chi-square test or Fisher definite probability methods calculate.Compare the totality of 4dermoscopic types use α=0.05 as test level,multiple comparison using bonferroni method,α’=α/k(k-1)/2=0.0083 as test level.Results:In the 51 patients diagnosed as basal cell carcinoma,dermoscopy diagnosed 40 casesas basal cell carcinoma,positive incidence is 78.43%.According to dermoscopic expression they were divided into four basic types:nodule basal cell carcinoma,twenty-four cases,pigmented basal cell carcinoma,nine cases,superficial basal cell carcinoma,five cases,morphea-like basal cell carcinoma,two cases.Pathological diagnosed thirty-nine cases basal cell carcinoma,positive incidence is 76.47%,diveded into seven types:nodule basal cell carcinoma,twenty-three cases,superficial basal cell carcinoma,four cases,adenoid basal cell carcinoma,one case,pigmented basal cell carcinoma,six cases,sclerosing basal cell carcinoma,two cases,keratotic basal cell carcinoma,two cases,micronodular basal cell carcinoma,one case.Compared with the dermoscopic diagnosis,sensitivity,coincidence rate,total coincidence rate,misdiagnosis rate,missed diagnosis rate,Youden index and Kappa value of the dermoscopic in diagnosis of skin were respectively 97.44%,83.33%,94.12%,16.67%,2.56%,0.808 and0.832.Four groups of the dermoscopic performance were not parallel with the common pathological type.The difference between four types was statistically significant(P<0.05),for the four pairwise comparison,any difference between the two groups also had significant(P<0.0083).The type of nodule mostly corresponded with the type of nodule in pathological classification,followed by the type of keratotic.The pathological changes of the pigmented type were the pigmented basal cell carcinoma,the type of superficial corresponded with the type of superficial in pathological classification,the type of morpher-like corresponded with the type of sclerosing in pathological classification.Conclusion:Compared with the pathological diagnosis,the dermoscopic has higher diagnostic consistency.Different basal cell carcinoma related to different pathological types.